Pancho - NOY-GRI-69

Code: NOY-GRI-69
Mercy ID: V-01875-01
Encounter Date: 04/12/2005
Last: Lopez
First: Griselda
DOB: 10/22/1969
County: Dekalb
Street: 4920 Winter Chapel Road
City: Dunwoody
State: GA

Zip

30360-

Cell

(404) 551-8942

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: YES
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: K. Aleman